Abstract
1159
Objectives: Review current diagnostic guidelines for inflammatory bowel disease. Emphasize the utility of FDG-PET/CT for global disease assessment in early diagnosis, and monitoring disease status.
Methods: Inflammatory Bowel Disease (IBD) is a chronic inflammatory condition of the gastrointestinal (GI) tract, further classified into 2 subtypes: ulcerative colitis and Crohn’s disease. IBD represents a major source of morbidity in an otherwise healthy demographic and is a risk factor for colon cancer, arthritis, and venous thromboembolism. The majority of IBD patients exhibit severe disease progression from initial inflammation to more serious penetrative conditions, necessitating intestinal surgery. Therefore, patients require early identification and close monitoring of IBD intensity in full body to mitigate complications. Current diagnostic procedures each demonstrate shortcomings for this process, which are especially concerning in pediatric populations that encompass a large portion of IBD patients. Structural imaging modalities, such as barium enema and fluoroscopy, and highly invasive procedures, such as ileocolonoscopy and endoscopy, each cannot completely diagnose IBD. 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) offers a solution to these problems. This exhibit will explore the clinical utility of global FDG-PET/CT in IBD diagnosis and demonstrate its superiority over other imaging modalities.
Results: FDG-PET/CT imaging is a sensitive method for the morphological and functional visualization of inflammation. FDG-PET/CT has previously demonstrated feasibility in early diagnosis, staging, and clinical management of are numerous GI diseases, and has already proven itself in the detection of inflammatory diseases including IBD. Novel studies have explained FDG-PET/CT’s abilities to provide a global disease assessment and close disease monitoring that other methodologies cannot provide. Though invasive procedures provide detailed analysis of a specific region, they are not viable for full-body, they require extensive time with deep perforation, and cannot be performed with frequency due to the preparation necessary and the high patient discomfort and risk of side effects. Barium studies pose risks of dangerous radiation amounts with lower sensitivity than desired for detection. Magnetic resonance imaging (MRI) has tried to address length of time and radiation amounts but has sacrificed specificity and has a high cost for low-quality imaging. FDG-PET/CT has efficiently addressed these issues and recent studies prove it’s potential. Not only is the methodology high in specificity and sensitivity, but it also provides faster diagnosis and examines the entire GI tract for concerns. Furthermore, there is little concern for repetitive scanning, allowing close monitoring of disease progression at typically a cheaper cost than comparable imaging techniques like MRI. Thus, we propose FDG-PET/CT is essential to the future of IBD diagnosis.
Conclusions: We argue global FDG-PET/CT will be the gold standard moving forward for the diagnosis and clinical management of IBD. This molecular imaging technique has demonstrated superiority over purely structural imaging modalities. Therefore, future studies should further explore the role of FDG-PET/CT in IBD, as well as compare results to other imaging modalities.
